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Whereas hackathons are widespread within and outside academia and have been argued to be a valid pedagogical method for teaching interdisciplinarity, no detailed frameworks or methods are available for conceptualizing and organizing educational hackathons, i.e., hackathons dedicated to best achieving pedagogic objectives. This paper is dedicated to introducing EDUCational Hackathons for learning how to solve Interdisciplinary Challenges (EDUCHIC) through: (1) defining the fundamental principles for framing an activity as an EDUCHIC, integrating principles from pedagogical methods, hackathon organization, and interdisciplinarity processes; (2) describing general properties that EDUCHIC possess as a consequence of the interaction of the fundamental principles; (3) developing operational guidelines for streamlining the practical organization of EDUCHIC, including an exhaustive end-to-end process covering all the steps for organizing EDUCHIC and practical frames for carrying the key decisions to be made in this process; and (4) a demonstration of these guidelines through illustrating their application for organizing a concrete EDUCHIC.

To review the longitudinal trajectories -- and the factors influencing their development -- of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.

Ethinylestradiol and drospirenone combined oral contraceptive formulations have been marketed for >20 years. Drospirenone has antimineralocorticoid and anti-androgenic effects that may offer several health benefits. Recently, 2 new drospirenone-containing oral contraceptives entered the market, 1 as a progestin-only pill containing 4 mg drospirenone and the other as a combined oral contraceptive containing 15 mg estetrol and 3 mg drospirenone. Estetrol has a unique differential effect on nuclear and membrane estrogen α-receptors when compared with other estrogens, leading to low impact on the liver, breast, and hemostasis parameters and a beneficial effect on the endometrium, vagina, cardiovascular system, bone, and brain. Phase 3 clinical studies demonstrated that the Pearl Index (pregnancies per 100-woman-years) for drospirenone alone is 4.0 in the United States and 0.93 in the European Union and for the estetrol-drospirenone combination it is 2.65 and 0.44, respectively. Drospirenone alone demonstrates high rates of unscheduled bleeding and low rates of scheduled bleeding, whereas the estetrol-drospirenone combination demonstrates a predictable and regular bleeding profile for most users with a high stable rate of scheduled bleeding and a low rate of unscheduled bleeding, reported primarily as spotting only. The adverse event profiles and discontinuation rates owing to adverse events are comparable, and no clinically significant effects were observed on metabolic parameters with either product. Hemostatic assays for drospirenone do not fully evaluate all parameters although the testing that is available suggests negligible effects, whereas validated hemostatic assays demonstrate that the estetrol-drospirenone combination has limited impact on hemostasis. The introduction of 4 mg drospirenone and 15 mg estetrol with 3 mg drospirenone are valuable additions to the contraceptive market. Adding estetrol to 3 mg drospirenone provides advantages of contraceptive efficacy and a regular, predictable bleeding profile with minimal impact on hemostasis parameters.

Abstract Deep learning (DL) has proven to be important for computed tomography (CT) image denoising. However, such models are usually trained under supervision, requiring paired data that may be difficult to obtain in practice. Diffusion models offer unsupervised means of solving a wide range of inverse problems via posterior sampling. In particular, using the estimated unconditional score function of the prior distribution, obtained via unsupervised learning, one can sample from the desired posterior via hijacking and regularization. However, due to the iterative solvers used, the number of function evaluations (NFE) required may be orders of magnitudes larger than for single-step samplers. In this paper, we present a novel image denoising technique for photon-counting CT by extending the unsupervised approach to inverse problem solving to the case of Poisson flow generative models (PFGM)++. By hijacking and regularizing the sampling process we obtain a single-step sampler, that is NFE = 1. Our proposed method incorporates posterior sampling using diffusion models as a special case. We demonstrate that the added robustness afforded by the PFGM++ framework yields significant performance gains. Our results indicate competitive performance compared to popular supervised, including state-of-the-art diffusion-style models with NFE = 1 (consistency models), unsupervised, and non-DL-based image denoising techniques, on clinical low-dose CT data and clinical images from a prototype photon-counting CT system developed by GE HealthCare.

Abstract The increasing prevalence of threats and violence against ambulance clinicians is a critical issue that has not been adequately studied. These incidents pose significant challenges to the provision of prehospital emergency care, affecting both the safety and well-being of the clinicians involved. This study aimed to explore the experiences of Swedish ambulance clinicians when encountering threats and violence during their work. A qualitative approach was used, involving semi-structured interviews with 11 ambulance clinicians from various regions of Sweden. The participants were selected to ensure diversity in gender, age, and educational background. The data were collected over three weeks in 2021 and analyzed using qualitative content analysis. The analysis revealed three key categories related to the challenges faced by ambulance clinicians: Police cooperation challenges, Strategies for a safe care environment, and Impact during and relief after stressful events. These categories highlight the complexities of managing threats and violence in the field. This study sheds light on the multifaceted challenges that ambulance clinicians face due to threats and violence. It underscores the urgent need for comprehensive training, effective communication, and clear role allocation in complex situations. Furthermore, it emphasizes the importance of organized support systems to help clinicians cope with the aftermath of stressful events.

Abstract Current therapeutics of endometriosis focus on hormonal disruption of endometriotic lesions (ectopic endometrium, EcE). Recent findings show higher glycolysis utilization in EcE, suggesting non-hormonal strategy for disease treatment that addresses cellular metabolism. Identifying metabolically altered cell types in EcE is important for targeted metabolic drug therapy without affecting eutopic endometrium (EuE). Here, using single-cell RNA-sequencing, we examine twelve metabolic pathways in paired samples of EuE and EcE from women with confirmed endometriosis. We detect nine major cell types in both EuE and EcE. Metabolic pathways are most differentially regulated in perivascular, stromal, and endothelial cells, with the highest changes in AMPK signaling, HIF-1 signaling, glutathione metabolism, oxidative phosphorylation, and glycolysis. We identify transcriptomic co-activation of glycolytic and oxidative metabolism in perivascular and stromal cells of EcE, indicating a critical role of metabolic reprogramming in maintaining endometriotic lesion growth. Perivascular cells, involved in endometrial stroma repair and angiogenesis, may be potential targets for non-hormonal treatment of endometriosis.

This study reports on a case study about multimodal work in a primary physics classroom focusing on forces. Previous research reports that students benefit from multimodal work in science classrooms. Yet, few systematic studies have been performed to reveal how students represent their experiences and ideas of science phenomena over time within and across different semiotic modes (e.g., through action, speech, writing, and image, including multimodal ensembles). The design of the lessons was built around a number of experimental activities, starting with a puzzling phenomenon and where students for each experiment predicted, observed, described, and tried to come up with explanations. Based on social-semiotics, we combined analysis at an overall level (long timescale and large grain size) and a detailed level (short timescale and small grain size) to shed light on how the science content was represented within and between modes over the teaching and learning period, and what content was expressed in these representations. Our findings reveal how students moved from focusing on attributes such as a "heavy" regarding artifacts used in the experiments, towards the central physics processes, such as one object exerting force on another object. Furthermore, we were able to detect that such "signs of learning" were shown in students' small-group discussions and multimodal texts following a carefully orchestrated multimodal exposition by the teacher. Hence, such a careful multimodal orchestration appeared to be critical for the students' meaning-making about the science content.

AIMS – To study the prevalence of cannabis use and drug-related problems among European adolescents and the utility of the prevention paradox. METHODS – Survey data from the European School Survey Project on Alcohol and Other Drugs (ESPAD) in 2007 in the 27 countries with information about drug use and drug-related problems was used. We analysed the proportion of all drug-related problems that occurred in a high risk group and among others who had used cannabis in the previous 12 months. The cut-off for the high risk group was chosen to include 10-15 % of the most frequent cannabis users. RESULTS – The high risk groups accounted for a substantial, but a minority, of drug-related problems among boys as well as girls. A minority of those who had used cannabis reported any drug-related problem. The proportion of adolescents with drug-related problems and the average number of problems increased with frequency of cannabis use. CONCLUSIONS – We find support for policy measures of more general character, supported by the prevention paradox. However, this does not exclude a policy supporting frequent drug users if they can be identified

Abstract Background The Apple Watch (AW) was the first smartwatch to provide wheelchair user (WCU) specific information on energy expenditure (EE), but was found to be inaccurate (i.e., it underestimated) and imprecise (i.e., the underestimation was variable). Insight is therefore needed into where these inaccuracies/imprecisions originate. Accordingly, the aim of this study was to investigate how much of the variation in AW EE is explained by heart rate (HR), in addition to other factors such as body mass and height, sex, age, physical activity level and disability. Methods Forty participants (20 WCU, 20 non-disabled) performed three 4-min treadmill wheelchair propulsion stages at different speed-incline combinations, on three separate days, while wearing an AW series 4 (setting: “outdoor push walking pace”). Linear mixed model analyses investigated how much of the variation in AW EE (kcal·min−1) is explained by the fixed effects AW HR (beats·min−1), body mass and height, sex, age, physical activity level and disability. Participant-ID was included as random-intercept effect. The same mixed model analyses were conducted for criterion EE and HR. Marginal R2 (R2m; fixed effects only) and conditional R2 (R2c; fixed and random effects) values were computed. An R2m close to zero indicates that the fixed effects alone do not explain much variation. Results Although criterion HR explained a significant amount of variation in criterion EE (R2m: 0.44, R2c: 0.92, p

Abstract Background Magnetic resonance imaging (MRI) of the brain is frequently performed on patients with neurofibromatosis type 1 (NF1), to detect and follow-up intracranial findings. In addition, NF1-related pathologies can appear in the jaws. This case study investigates if it is advantageous to assess the depicted parts of the jaws in the imaging of NF1 patients with intracranial findings, thereby detecting jaw pathologies in their initial stages. Case presentation We report on the 3-year management with clinical and radiological follow-ups of a central giant cell granuloma and a neurofibroma in the mandible of a patient with NF1 who underwent examinations with brain MRIs. A review of the mandible in the patient’s MRIs disclosed lesions with clear differences in progression rates. Conclusion NF1-related jaw pathologies may be detected in the early stages if the depicted parts of the jaws are included in the assessment of the imaging of NF1 patients with intracranial findings. This could impact the treatment of eventual pathologies before lesion progression and further damage to the vicinity.

Purpose Return to work often requires collaboration between different stakeholders. Rehabilitation coordination is a resource in coordinating efforts during sick leave to facilitate return to work. The purpose of the present study was to describe how people at risk for sick leave or on sick leave with mental health problems experienced rehabilitation coordination.Materials and Method The study had a qualitative approach using qualitative content analysis as described by Graneheim and Lundman. Eleven semi-structured interviews were conducted with persons at risk for sick leave or on sick leave due to mental health problems and with experience of rehabilitation coordination.Results The participants experience of rehabilitation coordination were described by the overarching theme Building a bridge with many bricks between the person and society. The theme was formed by four categories and eleven subcategories reflecting the complex context of rehabilitation coordination. The categories were Collaboration in a new setting, Unburdened within certain limits, The way back to work is a joint project and Recognising challenges beyond the person.Conclusions People with mental health problems experienced rehabilitation coordination as a meaningful link between healthcare and work. However, rehabilitation coordination needs to be more recognised within healthcare to increase accessibility. It seems important that interventions are directed not only towards the person, but also include the workplace for a sustainable return to work.

Abstract Back ground Knowledge concerning pulmonary function in adult patients with onset of idiopathic scoliosis before age 10 is sparse. A long-term follow-up (FU, mean 26 years, > 12 years after treatment) of pulmonary function (PF) in patients treated with brace or surgery due to idiopathic scoliosis with onset before the age of 10 was earlier performed. To evaluate whether a more severe reduction in pulmonary function leads to more rapid deterioration within a four-year period, this study was performed. Methods Twenty patients with the most reduced pulmonary function and 19 out of those with normal PF found at the long-term FU were reexamined 4 years later to evaluate further changes in pulmonary function. Patients underwent spirometry and arterial blood gas analysis and answered pulmonary symptom questionnaires. Results 70% of the reduced pulmonary function group had undergone surgery vs. 26% of the normal group. The mean age (47 vs. 43 years) at this FU and curve size (37° vs. 35°) at the 26-year FU were similar. The decline in forced vital capacity (FVC) % of predicted was similar in both groups over the four-year period, from 67 to 65% in the reduced PF group vs. 96 to 94% in the normal PF group. The total lung capacity (TLC) % of predicted did not change over time in either group. No patient reported worsening dyspnea symptoms. Only one patient in the reduced PF group showed low arterial oxygen tension, 8.4 kPa, not signifying respiratory insufficiency. Conclusion The age-related decline in FVC and TLC % of predicted did not differ between those with reduced and those with normal pulmonary function at the 26-year follow-up. Thus, these data do not infer increased rate of decline in the most deteriorated patients.

Abstract Background Alcohol-attributable medical disorders are prevalent among individuals with alcohol use disorder (AUD). However, there is a lack of research on prescriptions of pharmacological treatment for AUD in those with comorbid conditions. This study aims to investigate the utilization of pharmacological treatment (acamprosate, disulfiram and naltrexone) in specialist care among patients with AUD and comorbid medical diagnoses. Methods This was a descriptive register-based Swedish national cohort study including 132,728 adults diagnosed with AUD (N = 270,933) between 2007 and 2015. The exposure was alcohol-attributable categories of comorbid medical diagnoses. Odds ratios (OR) were calculated using mixed-effect logistic regression analyses for any filled prescription of acamprosate, disulfiram or oral naltrexone within 12 months post AUD diagnosis. Results Individuals with comorbid alcohol-attributable medical diagnoses had lower odds of filling prescriptions for any type of AUD pharmacotherapy compared to those without such comorbidities. Cardiovascular (OR = 0.41 [95% CI: 0.39–0.43]), neurological (OR = 0.52 [95% CI: 0.48–0.56]) and gastrointestinal (OR = 0.57 [95% CI: 0.54–0.60]) diseases were associated with the lowest rates of prescription receipt. The presence of diagnoses which are contraindications to AUD pharmacotherapy did not fully explain the low prescription rate. Conclusion There is a substantial underutilization of AUD pharmacotherapy in patients with AUD and comorbid medical disorders in specialist care. Increasing the provision of pharmacotherapy to this group of patients is essential and may prevent morbidity and mortality. There is a need to further understand barriers to medical treatment both from the patient and prescriber perspective.

Abstract Background Hazardous alcohol use is a leading risk factor for disability and death, yet observational studies have also reported reduced cardiovascular disease mortality among regular, low-level drinkers. Such findings are refuted by more recent research, yet have received significant media coverage. We aimed to explore: (1) how patients with cardiovascular diseases access health information about moderate drinking and cardiovascular health; (2) the perceived messages these sources convey, and (3) associations with own level of alcohol use. Methods We conducted a cross-sectional survey of patients in cardiology services at three hospitals in Sweden. The study outcome was hazardous alcohol use, assessed using the AUDIT-C questionnaire and defined as ≥ 3 in women and ≥ 4 in men. The exposure was accessing information sources suggesting that moderate alcohol consumption can be good for the heart, as opposed to accessing information that alcohol is bad for the heart. Health information sources were described using descriptive statistics. Gender, age and education were adjusted for in multiple logistic regression analyses. Results A total of 330 (66.3%) of 498 patients (mean age 70.5 years, 65% males) who had heard that drinking moderately can affect the heart described being exposed to reports that moderate alcohol use can be good for the heart, and 108 (21.7%) met criteria for hazardous alcohol use. Health information sources included newspapers (32.9%), television (29.2%), healthcare staff (13.4%), friends/family (11.8%), social media (8.9%) and websites (3.7%). Participants indicated that most reports (77.9%) conveyed mixed messages about the cardiovascular effects of moderate drinking. Exposure to reports of healthy heart effects, or mixed messages about the cardiovascular effects of alcohol, was associated with increased odds of hazardous alcohol use (OR = 1.67, 95%CI = 1.02–2.74). Conclusions This study suggests that many patients in cardiology care access health information about alcohol from media sources, which convey mixed messages about the cardiovascular effects of alcohol. Exposure to reports that moderate drinking has protective cardiovascular effects, or mixed messages about the cardiovascular effects of alcohol, was associated with increased odds of hazardous alcohol use. Findings highlight a need for clear and consistent messages about the health effects of alcohol.

This manuscript reflects on the affordances and limitations of methodological approaches commonly adopted by science education researchers examining learner identities. Our aims are to unpack the relative strengths and weaknesses of such approaches and note their respective prevalence. In so doing, we identify and critique studies which we consider exemplify the different approaches and, in turn, note the direction of fruitful developments and the nature of key challenges. From our review of the field, we suggest that three discrete methodological approaches can be identified: macro-studies within a psychological tradition; macro-studies within a sociological tradition; and micro-studies within an interpretive tradition. Our review comprised a critical analysis of papers included in the Web of Science databases published between 1998 and 2018. A total of 198 papers examining aspects of learner identity relating to science were identified. Of these, the majority (146) were categorised as micro-studies within an interpretive tradition. We discuss the implications of methodological choices for the advancement of understanding and further note ambiguities in the field particularly in relation to the ways in which learner identity research is conceived. We also raise questions for the field relating to the ways in which findings may be scaled, and how the field might develop to allow stronger theoretical and conceptual coherence.

The purpose of this manuscript is to explore how students perceive that online practices have enabled their participation in university physics programmes. In order to conceptualise how students bridge their science participation across physical and online spaces, we make use of the learning ecology perspective. This perspective is complemented with the notion of science capital, analysing how students have been able to strengthen different aspects of science capital through online participation. Data has been generated through semi-structured interviews guided by a timeline, constructed in collaboration between the interviewer and the interviewee. Twenty-one students enrolled in higher education physics have been interviewed, with a focus on their trajectories into higher education physics. The findings focus on four students who in various ways all have struggled to access science learning resources and found ways to utilise online spaces as a complement to their physical learning ecologies. In the manuscript, we show how online practices have contributed to the students' learning ecologies, e.g. in terms of building networks and functioning as learning support, and how resources acquired through online science practices have both use and exchange value in the wider science community. Online science participation is thus both curiosity driven and founded in instrumental reasons (using online tutoring to pass school science). Furthermore, we argue that online spaces have the potential to offer opportunities for participation and network building for students who do not have access to science activities and science people in their everyday surroundings.

Worksheets are common in science classrooms with an aim to support pupils' meaning-making, e.g., for guiding them in performing hands-on activities and documenting their experiences of such activities. Yet, there have been few systematic studies of pupils' disciplinary representations in worksheets. Drawing on systemic functional linguistics, we have analyzed fifth grade pupils' (age 10-11) multimodal texts in worksheets (n = 25) when they were working with shadow formation as part of their regular classroom activities. In the worksheets they were asked to first explain in writing why or why not a shadow was formed and then explain shadow formation through a drawing. At an overall level, we found that a majority of the pupils managed to express in writing why a shadow is formed, though it appeared to be more challenging for them to explain why a shadow is not formed. In their drawings, quite a few pupils managed to include several key aspects of shadow formation, at least when combining image with writing. For all tasks, the explanatory parts of the pupils' responses were often implicit. Based on our results, we suggest that pupils may benefit from teaching practices that integrate a parallel focus on form and content as a way to raise their awareness of, for instance, the affordances of different resources and how explanations can be structured. Such practices may support pupils to be able to consider and choose appropriate resources in their disciplinary texts.